Most psychoactive drugs alter our cognitive and emotional states, but
does chronic use implicate a pathological change in our mental
condition?
If we chronically alter transmitter pathways, adaptations will
certainly take place. Adaptations are expressed during addiction in
sensitization and desensitization of transmitter pathways. This leads to
an up- or downregulation of receptors and transporters and eventually
to tolerance as well as craving when the drug is withdrawn. These
adaptations originate out of natural compensation, but leave former drug
users with an imbalanced brain chemistry and an increased risk for
several mental disorders. Patients with substance disorders are twice as
likely to suffer from mood and anxiety disorders (National Institute on
Drug Abuse). Basically, all drugs alter dopaminergic regulation and
consequently, our motivation and ability to experience pleasure is
changed. Several drugs also cause neurotoxicity and can therefore easily
lead to permanent damage, e.g. depression after prolonged ecstasy use
due to serotonergic cell death.
Apart from emotional disturbances, the
most common drug-induced illness is psychosis; with alcohol (18%),
cannabis (13%) and cocaine (18%) being the most common inducers [1]. One
could blame everything on 'high risk drugs', yet, for many mental
disorders susceptibility genes have been found, e.g. the VAL/VAL variant
of the COMT-gene in cannabis users who go on to develop schizophrenia
[2]. Other factors, such as food intake, can severely affect mental
outcome after chronic drug use, for example vitamin b12 deficiency in
alcoholics, which can lead to several mental disorders, including
psychosis and depression.
Hence, aside from chronic substance use, our environmental and genetic
conditions play a decisive role in the development of long lasting
drug-induced mental pathologies.
[1] Drake et al., Am J Psychiatry, 2011
[2] Caspi et al., Biol Psychiatry, 2005
By Anne Schwerk, PhD Alumna, AG Neuronal Regeneration and Plasticity (Dr. med. Barbara Steiner)
This article originally appeared in CNS Volume 5, Issue 1, Mental Health Disorders
Showing posts with label Mental Health. Show all posts
Showing posts with label Mental Health. Show all posts
May 14, 2018
38% of Europeans affected by mental disease
Arguably, one of the most profound findings of 2011 was an
epidemiological report on the mental health status of the European
Union. Hans-Ulrich Wittchen and his international team of mental health
experts have unraveled striking data on just how extensively disorders
of the brain impact European society, and if the trend has been changing
over the last three decades.
With an initial goal to systematically assess the prevalence and burden of neurological and mental disorders in the European Union, experts from each disease category met and combined their data, only to find that it was difficult to segregate prevalence between mental and neurological disorders, due to significant overlap. However, it was possible to assess the burden of mental and neurological disease separately, when expressed as disability adjusted life years. Previous knowledge on this subject has been sparse - the World Health Organization reported an estimated 13% of global health burden to be from mental disorders. The World Mental Health Survey quotes that one in three adults suffers from a mental disorder.
Wittchen and colleagues set out to sample all of the EU countries as well as Norway, Iceland, and Switzerland. The team combined retrospective studies, consistent reanalyses of existing epidemiological datasets and supplementary survey data from national experts to gather the best possible comprehensive dataset. 19 epidemiological panels were dispatched and at least one international expert was recruited per diagnostic group. Data was collected as far back as 1980, when the first diagnostic criteria were published on an international level (Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Statistical Classification of Diseases and Related Health Problems (ICD)).
The results were startling: 38% of all Europeans are affected by disorders of the brain. Combined, mental and neurological diseases comprise Europe's largest disease burden, in terms of disability adjusted life years. The highest proportion of this burden was due to anxiety disorder, unipolar depression and insomnia.
Previously, Wittchen and colleagues had published a similar report in 2005, where the numbers were significantly more conservative, citing that 27% of the EU population are affected by mental disorder. However, this study produced a much more restrictive estimate due to age restrictions of the sample (only adults and not kids nor elderly were included), and a much more limited set of criteria for mental disorders. This time around, the team decided to get an unrestricted estimate regardless of age range or disease type.
Wittchen et al., Eur. Neuropsychopharmacol, 2011
Wittchen and Jacobi, Eur. Neuropsychopharmacol, 2005
World Health Organization, The Global Burden of Disease, 2004 Update (WHO, 2008)
By Gina Eom, Alumna MedNeuro
this article originally appeared in CNS Volume 5, Issue 1, Mental Health Disorders
With an initial goal to systematically assess the prevalence and burden of neurological and mental disorders in the European Union, experts from each disease category met and combined their data, only to find that it was difficult to segregate prevalence between mental and neurological disorders, due to significant overlap. However, it was possible to assess the burden of mental and neurological disease separately, when expressed as disability adjusted life years. Previous knowledge on this subject has been sparse - the World Health Organization reported an estimated 13% of global health burden to be from mental disorders. The World Mental Health Survey quotes that one in three adults suffers from a mental disorder.
Mental and Neurological Disorders Come to the Forefront: Significant Health Burden on Society
Wittchen and colleagues set out to sample all of the EU countries as well as Norway, Iceland, and Switzerland. The team combined retrospective studies, consistent reanalyses of existing epidemiological datasets and supplementary survey data from national experts to gather the best possible comprehensive dataset. 19 epidemiological panels were dispatched and at least one international expert was recruited per diagnostic group. Data was collected as far back as 1980, when the first diagnostic criteria were published on an international level (Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Statistical Classification of Diseases and Related Health Problems (ICD)).
The results were startling: 38% of all Europeans are affected by disorders of the brain. Combined, mental and neurological diseases comprise Europe's largest disease burden, in terms of disability adjusted life years. The highest proportion of this burden was due to anxiety disorder, unipolar depression and insomnia.
Previously, Wittchen and colleagues had published a similar report in 2005, where the numbers were significantly more conservative, citing that 27% of the EU population are affected by mental disorder. However, this study produced a much more restrictive estimate due to age restrictions of the sample (only adults and not kids nor elderly were included), and a much more limited set of criteria for mental disorders. This time around, the team decided to get an unrestricted estimate regardless of age range or disease type.
Wittchen et al., Eur. Neuropsychopharmacol, 2011
Wittchen and Jacobi, Eur. Neuropsychopharmacol, 2005
World Health Organization, The Global Burden of Disease, 2004 Update (WHO, 2008)
By Gina Eom, Alumna MedNeuro
this article originally appeared in CNS Volume 5, Issue 1, Mental Health Disorders
November 06, 2017
On Mind, (White) Matter and Meditation
In our modern times, everyone rushes between appointments, fulfills
work-related tasks all day and is busy with several means of
self-optimization. In a bid to find their inner center again and rest,
people are increasingly turning to centuries-old traditions like yoga and meditation.
Meditation is a concept from several Asian spiritual traditions where one’s attention is focused on a single thing such as breathing, bodily sensations or certain words or phrases known as “mantras”. For example, an easy approach is progressive muscle relaxation, where you consecutively contract and then relax different muscle groups to focus on that particular sensation. In principle, meditation means turning away from distractions of any form and concentrating on the present moment. While it sounds relatively simple, it is not easy to escape outer and inner noise. To those wondering whether they meditate correctly, there is an easy way of checking: "if you are feeling better at the end, you are probably doing it right." [1]. Another aspect of meditative practice (which appears very Buddhist in its own right) is that there is no right way to meditate because there is no goal to reach. Instead, the journey is the real aim [2]. And just like physical exercise, you will perform better with practice.
There Are Many Paths to Meditation
What actually happens during meditation that drives Homo economicus to adopt centuries-old traditions to calm down? For several decades, science has been trying to elucidate the psychological and physiological mechanisms behind mindfulness and meditation. Unfortunately, despite increasing popularity in research, this particular field of study faces severe methodological problems: there is an immense degree of individual variety among the general background of neuro-connectivity, meditation practice, and expertise of the subjects. As a consequence, and even though researchers readily make use of EEG, fMRI, PET and other sophisticated neuroimaging techniques, results are often inconclusive.
One of the earliest studies reported a decrease in blood pressure of hypertensive patients following meditation [3]. EEG studies showed a reduced frequency of alpha and theta waves linked to meditative state [4]. Depending on the type and tradition, meditation may lead to different effects. For example, researchers found increasing sympathetic activity and arousal with practice of Hindu tantric meditation as opposed to heightened parasympathetic activity and calmness when following other traditions [5]. Network connectivity studies with expert Taoist meditators reported significant differences in brain white matter and functional network topology between resting state and during meditation [6], while others find activation of basal ganglia (caudate body), limbic system (entorhinal cortex) and medial prefrontal cortex (MPFC) [7].
Changes in brain activity and/or connectivity may also underlie the beneficial effect of meditation and mindfulness on pain. Pain consists of two elements: the sensory perception and the cognitive evaluation of this perception as painful. A review discussed the changes in brain activity with meditation practice as a consequence of increased thalamus and insula activity (where the sensation itself is processed) and a reduction in MPFC activity (responsible for the evaluation of pain). Therefore, it seems that meditation and mindfulness are effective because they alter the way sensory perception is assessed [8], a concept which may be applicable to a variety of health and mental problems.
Meditation to Improve Mental Health?
Recently, a large review took a deeper look at these topics [9]. Of all evaluated 18,000 citations, only 47 studies showed satisfactory methodological quality and could be included. From these, the authors conclude that meditation is likely not superior to active treatments (e.g. psychotherapy or medication) regarding stress-related problems, such as anxiety, depression and pain, yet a legitimate alternative in terms of side effects. One of the best accepted effects of meditation and mindfulness is stress reduction. It is not surprising, therefore, that big tech companies have started using these practices as a general leadership strategy to increase creativity and productivity [10].
What about you? Have you got experience with stress or ever lost your head over endless to-do-lists and half-baked could-be-done ideas? Maybe it is your turn to take your time and shape up your brain connections in order to be more creative, focused and happy!
by Bettina Schmerl, PhD Student AG Shoichet
[1] http://bit.ly/1CfRBPx
[2] http://bit.ly/29s6NAn
[3] Benson et al., J Chronic Dis. 1974
[4] Cahn and Polich. Psychol Bull. 2006
[5] Amihai and Kozhevnikov. Biomed Res Int. 2015
[6] Jao et al., Brain Connectivity. 2016
[7] Sperduti et al., Conscious Cogn. 2012
[8] Zeidan and Vago, Ann Y Acad Sci, 2017
[9] Goyal et al., JAMA Intern Med. 2014
[10] http://bit.ly/1TmWHgu
Meditation is a concept from several Asian spiritual traditions where one’s attention is focused on a single thing such as breathing, bodily sensations or certain words or phrases known as “mantras”. For example, an easy approach is progressive muscle relaxation, where you consecutively contract and then relax different muscle groups to focus on that particular sensation. In principle, meditation means turning away from distractions of any form and concentrating on the present moment. While it sounds relatively simple, it is not easy to escape outer and inner noise. To those wondering whether they meditate correctly, there is an easy way of checking: "if you are feeling better at the end, you are probably doing it right." [1]. Another aspect of meditative practice (which appears very Buddhist in its own right) is that there is no right way to meditate because there is no goal to reach. Instead, the journey is the real aim [2]. And just like physical exercise, you will perform better with practice.
There Are Many Paths to Meditation
What actually happens during meditation that drives Homo economicus to adopt centuries-old traditions to calm down? For several decades, science has been trying to elucidate the psychological and physiological mechanisms behind mindfulness and meditation. Unfortunately, despite increasing popularity in research, this particular field of study faces severe methodological problems: there is an immense degree of individual variety among the general background of neuro-connectivity, meditation practice, and expertise of the subjects. As a consequence, and even though researchers readily make use of EEG, fMRI, PET and other sophisticated neuroimaging techniques, results are often inconclusive.
 |
| source: http://bit.ly/2uWg0dA |
One of the earliest studies reported a decrease in blood pressure of hypertensive patients following meditation [3]. EEG studies showed a reduced frequency of alpha and theta waves linked to meditative state [4]. Depending on the type and tradition, meditation may lead to different effects. For example, researchers found increasing sympathetic activity and arousal with practice of Hindu tantric meditation as opposed to heightened parasympathetic activity and calmness when following other traditions [5]. Network connectivity studies with expert Taoist meditators reported significant differences in brain white matter and functional network topology between resting state and during meditation [6], while others find activation of basal ganglia (caudate body), limbic system (entorhinal cortex) and medial prefrontal cortex (MPFC) [7].
Meditation focuses on the moment
Changes in brain activity and/or connectivity may also underlie the beneficial effect of meditation and mindfulness on pain. Pain consists of two elements: the sensory perception and the cognitive evaluation of this perception as painful. A review discussed the changes in brain activity with meditation practice as a consequence of increased thalamus and insula activity (where the sensation itself is processed) and a reduction in MPFC activity (responsible for the evaluation of pain). Therefore, it seems that meditation and mindfulness are effective because they alter the way sensory perception is assessed [8], a concept which may be applicable to a variety of health and mental problems.
Meditation to Improve Mental Health?
Recently, a large review took a deeper look at these topics [9]. Of all evaluated 18,000 citations, only 47 studies showed satisfactory methodological quality and could be included. From these, the authors conclude that meditation is likely not superior to active treatments (e.g. psychotherapy or medication) regarding stress-related problems, such as anxiety, depression and pain, yet a legitimate alternative in terms of side effects. One of the best accepted effects of meditation and mindfulness is stress reduction. It is not surprising, therefore, that big tech companies have started using these practices as a general leadership strategy to increase creativity and productivity [10].
What about you? Have you got experience with stress or ever lost your head over endless to-do-lists and half-baked could-be-done ideas? Maybe it is your turn to take your time and shape up your brain connections in order to be more creative, focused and happy!
by Bettina Schmerl, PhD Student AG Shoichet
This article originally appeared September 2017 in CNS Volume 10, Issue 3, Spirituality in Science
[1] http://bit.ly/1CfRBPx
[2] http://bit.ly/29s6NAn
[3] Benson et al., J Chronic Dis. 1974
[4] Cahn and Polich. Psychol Bull. 2006
[5] Amihai and Kozhevnikov. Biomed Res Int. 2015
[6] Jao et al., Brain Connectivity. 2016
[7] Sperduti et al., Conscious Cogn. 2012
[8] Zeidan and Vago, Ann Y Acad Sci, 2017
[9] Goyal et al., JAMA Intern Med. 2014
[10] http://bit.ly/1TmWHgu
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